Findings demonstrate a lack of link between metabolic syndrome and radiographic spine osteoarthritis (OA).

• This study included 2,252 persons older than 50 years who had plain radiography of the lumbar spine during the Korea National Health and Nutrition Examination Survey (KNHANES) 2012, to assess if metabolic syndrome is linked with radiographic spine OA in the Korean population.

• Spine OA prevalence was 28.1% (n = 689), and metabolic syndrome prevalence in spine OA was not different vs that in controls.

• Significant difference in the cumulative number of metabolic syndrome components was found between spine OA and controls.

• A higher proportion of metabolic syndrome and its cumulative components was found in those with Kellgren-Lawrence (K-L) grade 1 or grade 2 vs those of K-L grade 0.

• Two or 3 or more metabolic syndrome components were found to be significantly linked with spine OA.

• A weak association between abnormal waist circumference and spine OA (odds ratio 1.233) was observed.

• In multivariate logistic regression analysis, older age and female gender were found to be associated with spine OA, but not metabolic syndrome.